Skip to main content

Dyslipidemia among adult people living with HIV on dolutegravir – based antiretroviral therapy at a private tertiary hospital in Kampala, Uganda: burden and determinants



Understanding the burden of dyslipidemia and its associated factors among adult people living with HIV on dolutegravir (DTG) based anti-retroviral therapy (ART) is critical to provide clinical guidance and risk reduction strategies in our setting.


We conducted a cross-sectional study on adult people living with HIV on DTG based ART between July and August 2022 at Mengo Hospital, a private not for profit missionary hospital owned by the Church of Uganda. Dyslipidemia was defined as: Total cholesterol (TC) ≥ 5.2 mmol/l, or high-density lipoprotein (HDL) < 1 mmol/l for men and < 1.3 mmol/l for women, or triglycerides (TG) ≥ 1.7 mmol/l, and low-density lipoprotein (LDL) ≥ 3.4 mmol/l. A participant was considered to have dyslipidemia if they had any of the lipid profile parameters in the above ranges. Socio-demographic information, clinical data and behavioral characteristics were collected. Fasting lipid profile and fasting blood glucose levels were also measured. Bivariate and multivariate analyses were done using a generalized linear model regression of the Poisson family with a log link (modified Poisson) using robust standard errors since the prevalence of dyslipidemia was more than 10%. Adjusted prevalence ratios (PR) were reported with their 95% confidence intervals (CI). A p-value of less than 0.05 was considered statistically significant.


A total of 341 participants were included. The prevalence of dyslipidemia was 78.0%, (95%CI:73.3–82.1). The highest prevalence was for low HDL (72.1%, 95%CI 67.1–76.7) followed by high TG (20.2%, 95%CI: 16.3–24.9), high TC (12.0%, 95%CI: 9.0–15.9) and high LDL (6.5%, 95%CI: 4.3–9.6). Female sex (aPR:1.55, 95%CI: 1.32–1.84, p < 0.001) and previous use of protease inhibitor (PI) based ART regimen (aPR:1.26, 95%CI: 1.04–1.53, p = 0.018) were significantly associated with dyslipidemia.


We demonstrate that the prevalence of dyslipidemia is very high as it was present in more than three quarters of the study participants. Female sex and previous use of PI based ART regimen were significantly associated with dyslipidemia. Management of dyslipidemia should be integrated in the HIV treatment package and we recommend further inquiry into the temporal relationship between dyslipidemia and DTG among ART patients, if any.

Peer Review reports


In 2021, 38 million people were estimated to be living with HIV world-wide, of whom 680,000 died from AIDS-related illnesses [1]. Sub-Saharan Africa has more than two-thirds of all people living with HIV (PLHIV) globally making it the hardest affected region in the world [2].With this region, Eastern and Southern Africa regions are the most heavily affected by HIV, accounting for approximately 55% of all PLHIV [3]. The burden of HIV in Uganda is still high with about 1.3 million adults (≥ 15 years) living with HIV by 2020, accounting for more than 90% of the national burden by age [4]. In addition, HIV related deaths were the third commonest in Uganda in 2019 [5]. However, there has been a steady increase in PLHIV on ART which has saved and prolonged many lives.

The World Health Organization (WHO) recommends the use of dolutegravir (DTG) as the preferred first-line and second-line treatment option for all PLHIV, including pregnant women and those of childbearing age. This is based on new evidence that DTG more effective, easier to take and has fewer side effects than available alternative drugs used for treatment of HIV among PLHIV [6].

Since 2018, the Uganda Ministry of Health (MoH) recommends the use of DTG in combination with tenofovir (TDF) and lamivudine (3TC) as the preferred first line regimen for treatment of adults living with HIV [7].

PLHIV on ART are known to experience several side effects and adverse drug reactions including dyslipidaemia [8]. For instance, patients on stavudine, didanosine, zidovudine, lamivudine and efavirenz, protease inhibitors (including atazanavir and ritonavir) reported elevated triglycerides (TG), total cholesterol (TC) and reduced high-density lipoprotein (HDL) [9,10,11]. PIs were also reported to elevate low density lipoprotein (LDL) [12, 13]. However, DTG, together with other integrase strand transfer inhibitors (INSTIs), seem to have a higher incidence of dyslipidemia compared to those on non-nucleoside reverse transcriptase inhibitors (NNRTIs) like efavirenz [14].

Additionally, clinical trials in other settings have reported a significantly greater increase in baseline total cholesterol TC and LDL among PLHIV on DTG in black African populations [15, 16].

In Uganda, studies have focused on hyperglycemia and diabetes mellitus (DM) among PLHIV on a DTG-based ART regimen [17, 18] and yet, poorly managed dyslipidemia is a risk factor for non-communicable diseases [like hypertension (HTN), diabetes (DM)] and cardiovascular disease [19].

Moreover, lipid profile levels are not routinely measured among PLHIV in Uganda due to cost. There is a degree of uncertainty on the prevalence of dyslipidemia in PLHIV on DTG-based regimens and its associated factors. The current study determined the burden and factors associated with dyslipidemia among adults receiving DTG-based ART regimens at Mengo Hospital in Kampala, Uganda.


This was a cross-sectional study with both descriptive and analytical components carried out in the counseling and home care department of a private not for profit missionary tertiary hospital called Mengo Hospital in Kampala, Uganda from July to August 2022. The clinic operates daily and has an estimated outpatient attendance of about 400. The clinic serves about 8800 active PLHIV ART, with approximately 7000 adults on DTG-based ART. Using the systematic sampling procedure, every 4th participant was sampled and 341 adults (≥ 18-years) with confirmed HIV-positive infection were enrolled into the study upon providing written informed consent. These adults were on a DTG based ART regimen for more than 6 months and had self-reported fasting for at least 6 h.

Participants who were bed ridden, had a history of use of lipid - lowering therapy, with cardiovascular risk factors, or using lipid - affecting agents (such as thiazides, beta blockers, antipsychotics, steroids) before switch or initiation to a DTG-based ART, those who were unable to comprehend either English or Luganda (the local language used in central Uganda) were excluded from the study.

Data collection

Two trained enumerators (diploma nurses) administered a pretested questionnaire to collect sociodemographic (age, sex, marital status, residence, education level, employment status and distance from the health facility) and behavioral characteristics i.e., smoking status, alcohol intake and physical activity. Clinical data collected were past medical history, height, weight, blood pressure (BP), fasting blood sugar (FBS), baseline CD4 + T cell count, HIV duration in years, duration on DTG-based ART in months and duration on ART in years.

Participant weight, exclusive of heavy outer garments, hair ornaments and shoes, if any, was measured using the seca weighing scale in complete kilograms. Height was abstracted from the patient files. The body mass index (BMI) was then computed as weight (in kg)/height (in m2).

Blood pressure (BP) was measured by a pretested automatic sphygmomanometer of mercury type in a sitting position 10 min after rest. Two measurements, 5 min apart were recorded for consistency. A third measurement was taken as final in case of a 10mmHg difference in systolic BP in the first two readings.

About 4 ml of a blood sample were aseptically collected from each participant by a qualified laboratory staff and placed in a yellow top vacutainer with clot activator for the determination of fasting lipid profile levels. Patient files were sorted basing on whether they were on DTG based ART regimen or not. In addition to being reminded about their appointment date a day before the scheduled visit, patients were also requested not to eat anything after their last meal of that day. Fasting blood sugar levels were determined using a Freestyle glucometer (Abott Laboratories, Canada) for all eligible participants. A sterile single use lancet was used to prick a participant’s disinfected finger and a small drop of the blood placed onto the glucometer strip already mounted into the glucometer. The blood sugar levels were read off and recorded in mmol/L. The results were recorded in a laboratory results tool. Venous blood samples were collected from the eligible participants early in the morning before they ate anything and were allowed to clot for at least 3 min then later centrifuged at 2400 revolutions/min for 5 min at Mengo Hospital ART clinic laboratory. The serum obtained was pipetted into cryogenic vials, stored in a refrigerator at < 40 C. These were later transported under cold chain in a sample carrier with ice-packs and a temperature monitoring device by the principal investigator for analysis of lipid profile using the Cobas 3000 chemistry analyzer (Roche Diagnostics, USA) at Jinja Regional Referral Hospital, Uganda laboratory in two lots. This was done to reduce the cost of lipid analysis that was so high among laboratories in Kampala.

Statistical analysis

Data was analysed using STATA V.14.0 (StataCorp. 2013. Stata Statistical Software: Release 14) in which all continuous variables were summarised as medians and ranges while the categorical variables were summarised as percentages and proportions. The prevalence of dyslipidaemia was calculated as the percentage of participants with dyslipidaemia over the total number of study participants. Data was assessed for collinearity. At bivariate and multivariate analysis, we used a generalized linear model regression of the Poisson family with a log link (modified Poisson) with robust standard errors to analyse the factors associated with dyslipidaemia among study participants since the prevalence was more than 10% [20]. In the multivariate analysis, we included variables with p-value of ≤ 0.2 at bivariate analysis as well as those known from literature such as age, duration on ART, physical activity, HIV duration and alcohol use. Interaction was assessed by forming two-way product terms with variables which were significantly associated with dyslipidaemias (p < 0.05) using the chunk test. Confounding was assessed by checking if the variables changed the estimates by greater than or equal to 10%. CIs were presented at 95% level of significance along with the p values. Statistical significance was considered at a p value of less than 0.05.


Majority of the participants were female 66.9% (228/341) with median age of 43 years (IQR: 36–50), residing in rural areas 71.3% (243/341) and married 54.8% (187/341). Of the participants enrolled, 29.9% (102/341) were obese, with median HIV duration of 9.5 years (IQR: 4.9–12.7) and median DTG duration of 35.4 months (IQR: 23.8–40.6). The majority of participants were on TDF/3TC/DTG 96.5% (329/341) and were previously on an NNRTI-based regimen 82.7% (282/341). Only 5.3% (18/341) of the participants had a high FBG and 19.4% (66/341) of them had HTN (Table 1).

Table 1 Sociodemographic and clinical characteristics of study participants on DTG-based ART in Mengo Hospital, Kampala, Uganda, 2022 (n = 341)

The overall prevalence of dyslipidemia was 78.0% (95%CI 73.3–82.1). The highest prevalence was for low HDL 72.1% (95%CI 67.1–76.7) followed by high TG 20.2% (95%CI 16.3–24.9), high TC 12.0%, (95%CI 9.0–15.9) and high LDL 6.5%, (95%CI 4.3–9.6) (Table 2).

Table 2 Dyslipidemia among study participants on DTG-based ART in Mengo Hospital, Kampala, Uganda, 2022 (n = 341)

At bivariate analysis, being female (cPR:1.53, 95%CI 1.30–1.81, p < 0.001), having up to primary education or less (cPR – 1.14, 95%CI 1.02–1.27, p = 0.021), being on DTG based ART regimen for < 2 years (cPR: 1.13, 95%CI 1.01–1.26, p = 0.034), overweight (cPR: 1.13, 95%CI 0.98–1.31, p = 0.093), obese (cPR: 1.24, 95%CI 1.09–1.31, p = 0.001) and previous use of PI based ART regimen (cPR: 1.14, 95%CI 0.93–1.38, p = 0.199) had a p-value less than 0.2 hence they were considered for multivariate analysis (Table 3). Additionally, age, duration on ART, physical activity, duration of HIV infection, and alcohol use were forced into multivariate analysis.

Table 3 Bivariate analysis for sociodemographic and clinical characteristics of study participants on DTG-based ART in Mengo Hospital, Kampala, Uganda, 2022 (n = 341)

At multivariate analysis, being female (aPR:1.55, 95%CI 1.32–1.847, p < 0.001) and previous use of PI based ART regimen (aPR:1.26, 95%CI 1.04–1.53, p = 0.018) were significantly associated with dyslipidemia (Table 4).

Table 4 Multivariate analysis of factors associated with dyslipidemia among study participants on DTG-based ART in Mengo Hospital, Kampala, Uganda, 2022 (n = 341)

Discussion of results

The overall prevalence of dyslipidemia in the current study is 78.0% with the prevalence of low HDL cholesterol at 72.1%. This prevalence is high as three quarters of the respondents have dyslipidemia. In contrast, high TC, high LDL and high TG are relatively low, with less than a quarter of the population having any of these forms of dyslipidemia. This high prevalence of dyslipidemia (low HDL cholesterol) could reflect the high prevalence in the general population. Female participants were twice the male participants (66.9% vs. 33.1). In addition, there is a positive association between increasing age and a rise in the prevalence of low HDL, with a steeper increase among women than for men [21]. In our study, the median age was 43 years (IQR: 36–50) with more than half of the participants aged 40 years and above. Therefore, this high prevalence of dyslipidemia could have been as a result of enrolling older patients and mostly female.

Previous studies have demonstrated that initiation of NNRTI based ART regimens results in increases in HDL of approximately 40% depending on the agent used, with increases in TC, LDL and TG also seen, although the TG increases are usually not as severe as those seen with some PIs [22]. However, this finding is contrary to our results in which the prevalence of low HDL cholesterol is high among the study participants probably because not all patients respond similarly to antiretroviral regimens [23].

The high prevalence of dyslipidemia means that most of the study participants are at a risk of atherosclerotic cardiovascular disease events and could benefit from statin initiation if clinically indicated [24].

A cross-sectional study of 597 PLHIV on the prevalence of low HDL among adults receiving ART for at least 6 months in Zambia from April to December 2019 reported a high proportion of young adults (75%) and adults (58%) with low HDL who were on DTG-based ART regimens [25]. Similar studies in SSA on the prevalence of dyslipidemia among PLHIV on ART regimens other than DTG-based ones have reported prevalence ranging from 15.9 to 83.3% [26,27,28,29,30].

A recent cross-sectional study in Halibet National Referral Hospital and Orotta National Medical Surgical Referral Hospital Eritrea from March to June, 2018 reported a prevalence of 86.6% among PLHIV [31].

The factors that were significantly associated with dyslipidemia among study participants on DTG based ART regimen were being female and previous use of PI based ART regimen. Surprisingly, age, duration on ART, physical activity, duration of HIV infection, alcohol use, education level, being on DTG based ART regimen for less than 2 years, being overweight and being obese were not significantly associated with dyslipidemia.

Females were 1.55 times as likely to have dyslipidemia than males. This is line with findings from a cross sectional study by Benson and colleagues in 2021. Benson et al.’s study reported that females were 2.54 times more likely to have low HDL compared with males. Gender differences have been partly explained by the dramatic lipid profile changes in women than in men due to complex hormonal modifications throughout their life time, especially those related to pregnancy and menopause [32]. In addition, estrogen and testosterone have been reported to have influence on the activities of hepatic lipase which plays a role in HDL metabolism and its levels are inversely related with those of HDL [33]. These hormones respectively tend to decrease and increase hepatic lipase levels and as a result, women tend to have higher HDL levels than men [34,35,36].

Study participants taking a PI based ART regimen before switching to a DTG-based regimen were 1.26 times as likely to have dyslipidemia than those on a previous NNRTI based ART regimen. Integrase strand transfer inhibitors (INSTI) have been reported to have a lower incidence of dyslipidemia than ritonavir boosted protease inhibitors but higher rate compared with those on NNRTI [14]. Therefore, dyslipidemia could have existed among these participants due to previous exposure to PIs. In a large observational cohort study to determine the improvement of lipid profile after switching from efavirenz or ritonavir-boosted PIs to rilpivirine or once-daily integrase inhibitors, the TC and TC/HDL ratio significantly decreased among participants switched from PI based regimens to DTG-based regimens within one year. However, reductions of LDL and TG levels were not statistically significant [37]. In this study, baseline lipid profile before switch were not established and therefore, we could not ascertain if the dyslipidemia was due to the previous ART exposure or other factors.

Strengths of the study

This is one of the first studies assessing dyslipidemia among patients on a DTG based regimen in Uganda thus laying a foundation for future research. Additionally, we managed to collect complete data from all variables considered in the study and only had one missing entry on CD4 count and the data collection process was standardized which increases the replicability and comparability of our findings with future studies.

Limitations of the study

We acknowledge the following limitations. First, a questionnaire was used to collect data with self-reporting on some variables (like true fasting status, substance abuse, alcohol use, smoking and familial diseases) which increases the chances of patients reporting desirable answers. Second, there was a possibility of selection bias due to elimination of potential study participants that had taken breakfast. Third, some variables like WHO stage, viral load and diet were not studied yet they have been consistently reported to be associated with dyslipidemia in other studies. Fourth, this was a cross-sectional study and therefore a temporal relationship between dyslipidemia and the covariates could not be determined. Fifth, we excluded participants using lipid-lowering therapy, with cardiovascular risk factors, or using lipid-affecting agents (such as thiazides, beta blockers, antipsychotics, steroids); no data available from these exclusions and sixth, we were unable to determine the cumulative exposure to PIs and NNRTIs at baseline and therefore the difference in dyslipidemia risk between the two regimens couldn’t be determined.


We demonstrate that the prevalence of dyslipidemia is very high as it was present in three quarters of the study participants on DTG based ART. This suggests that many people are at an increased risk of developing complications like cardiovascular diseases which arise from dyslipidemia. Female sex and previous use of PIs were significantly associated with dyslipidemia among adult patients on a DTG-based ART. We recommend further research to understand whether there is a temporal relationship between dyslipidemia and DTG among ART patients.

Data Availability

All available data can be obtained by contacting the corresponding author.







Anti-retroviral therapy




Body mass index


Coronary Artery Disease


Cluster of differentiation 4


Confidence interval


Diabetes Mellitus




Highly active antiretroviral therapy


High density lipoprotein


Human immunodeficiency virus




Institute for Health Metrics and Evaluation


Integrase strand transfer inhibitor


Low density lipoprotein


Ministry of Health


National Cholesterol Education Program


Nucleoside Reverse Transcriptase Inhibitors


People living with HIV


Prevalence ratio


Total cholesterol






The Joint United Nations Programme on AIDS


World Health Organization


  1. Global HIV. & AIDS statistics — Fact sheet [press release]. 2021.

  2. UNAIDS. The Global HIV/AIDS Epidemic. 2021.

  3. UNAIDS. UNAIDS epidemiological estimates. 2021.

  4. MoH. News & events updates. Uganda AIDS Commission; 2020.

  5. IHME. GBD 2019 cause and risk summaries. Uganda; 2020.

  6. WHO. WHO recommends dolutegravir as preferred HIV treatment option in all populations. Geneva, Switzerland: World Health Organization; 2019.

    Google Scholar 

  7. MoH. Consolidated guidelines for the prevention and treatment of HIV and AIDS in Uganda. Ministry of Health Kampala, Uganda; 2018.

  8. da Cunha J, Maselli LMF, Stern ACB, Spada C, Bydlowski SP. Impact of antiretroviral therapy on lipid metabolism of human immunodeficiency virus-infected patients: Old and new Drugs. World J Virol. 2015;4(2):56.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Jones R, Sawleshwarkar S, Michailidis C, Jackson A, Mandalia S, Stebbing J, et al. Impact of antiretroviral choice on hypercholesterolaemia events: the role of the nucleoside reverse transcriptase inhibitor backbone. HIV Med. 2005;6(6):396–402.

    Article  CAS  PubMed  Google Scholar 

  10. Dube MP, Parker RA, Tebas P, Grinspoon SK, Zackin RA, Robbins GK, et al. Glucose metabolism, lipid, and body fat changes in antiretroviral-naive subjects randomized to nelfinavir or efavirenz plus dual nucleosides. Aids. 2005;19(16):1807–18.

    Article  CAS  PubMed  Google Scholar 

  11. Doser N, Sudre P, Telenti A, Wietlisbach V, Nicod P, Darioli R, et al. Persistent dyslipidemia in HIV-infected individuals switched from a protease inhibitor-containing to an efavirenz-containing regimen. JAIDS J Acquir Immune Defic Syndr. 2001;26(4):389–90.

    Article  CAS  PubMed  Google Scholar 

  12. Oh J, Hegele RA. HIV-associated dyslipidaemia: pathogenesis and treatment. Lancet Infect Dis. 2007;7(12):787–96.

    Article  CAS  PubMed  Google Scholar 

  13. Holmberg SD, Moorman AC, Williamson JM, Tong TC, Ward DJ, Wood KC, et al. Protease inhibitors and cardiovascular outcomes in patients with HIV-1. The Lancet. 2002;360(9347):1747–8.

    Article  CAS  Google Scholar 

  14. Byonanebye D. Incidence of dyslipidemia in people with HIV who are treated with integrase inhibitors versus other antiretroviral agents. AIDS. 2021;Publish Ahead of Print.

  15. Kouanfack C, Mpoudi-Etame M, Omgba Bassega P, Eymard-Duvernay S, Leroy S, Boyer S, et al. Dolutegravir-based or low-dose efavirenz-based regimen for the treatment of HIV-1. N Engl J Med. 2019;381(9):816–26.

    Article  PubMed  Google Scholar 

  16. Venter WDF, Moorhouse M, Sokhela S, Fairlie L, Mashabane N, Masenya M, et al. Dolutegravir plus two different prodrugs of Tenofovir to treat HIV. N Engl J Med. 2019;381(9):803–15.

    Article  CAS  PubMed  Google Scholar 

  17. Namara D, Schwartz JI, Tusubira AK, McFarland W, Birungi C, Semitala FC, et al. The risk of hyperglycemia associated with use of dolutegravir among adults living with HIV in Kampala, Uganda: a case-control study. Int J STD AIDS. 2022;33(14):1158–64.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Mulindwa F, Castelnuovo B, Brusselaers N, Bollinger R, Rhein J, Edrisa M, et al. Blood glucose trajectories and incidence of Diabetes Mellitus in Ugandan people living with HIV initiated on dolutegravir. AIDS Res Ther. 2023;20(1):15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Asare GA, Santa S, Ngala RA, Asiedu B, Afriyie D, Amoah AG. Effect of hormonal contraceptives on lipid profile and the risk indices for Cardiovascular Disease in a Ghanaian community. Int J Women’s Health. 2014;6:597.

    Article  Google Scholar 

  20. Zou G. A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004;159(7):702–6.

    Article  PubMed  Google Scholar 

  21. Harman JL, Griswold ME, Jeffries NO, Sumner AE, Sarpong DF, Akylbekova EL, et al. Age is positively associated with high-density lipoprotein cholesterol among African americans in cross-sectional analysis: the Jackson Heart Study. J Clin Lipidol. 2011;5(3):173–8.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Haubrich RH, Riddler SA, DiRienzo AG, Komarow L, Powderly WG, Klingman K, et al. Metabolic outcomes in a randomized trial of nucleoside, nonnucleoside and protease inhibitor-sparing regimens for initial HIV treatment. Aids. 2009;23(9):1109–18.

    Article  CAS  PubMed  Google Scholar 

  23. Feeney ER, Mallon PW. HIV and HAART-Associated Dyslipidemia. Open Cardiovasc Med J. 2011;5:49–63.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Grinspoon SK, Fitch KV, Zanni MV, Fichtenbaum CJ, Umbleja T, Aberg JA, et al. Pitavastatin to Prevent Cardiovascular Disease in HIV Infection. N Engl J Med. 2023;389(8):687–99.

    Article  CAS  PubMed  Google Scholar 

  25. Hamooya BM, Musonda P, Mutale W, Masenga SK, Halwiindi H, Mutengo KH, et al. Prevalence of low high-density lipoprotein among young adults receiving antiretroviral therapy in Zambia: an opportunity to consider non-communicable Diseases in resource-limited settings. PLoS ONE. 2021;16(2):e0247004.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Amberbir A, Singano V, Matengeni A, Ismail Z, Kawalazira G, Chan AK, et al. Dyslipidemia among rural and urban HIV patients in south-east Malawi. PLoS ONE. 2018;13(5):e0197728.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Ombeni W, Kamuhabwa AR. Lipid Profile in HIV-Infected patients using first-line antiretroviral Drugs. J Int Assoc Provid AIDS Care. 2016;15(2):164–71.

    Article  PubMed  Google Scholar 

  28. Dave JA, Levitt NS, Ross IL, Lacerda M, Maartens G, Blom D. Anti-retroviral therapy increases the prevalence of dyslipidemia in South African HIV-infected patients. PLoS ONE. 2016;11(3):e0151911.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Njoroge A, Guthrie B, Bosire R, Wener M, Kiarie J, Farquhar C. Low HDL-cholesterol among HIV-1 infected and HIV-1 uninfected individuals in Nairobi, Kenya. Lipids Health Dis. 2017;16(1):1–7.

    Article  Google Scholar 

  30. Kemal A, Teshome MS, Ahmed M, Molla M, Malik T, Mohammed J, et al. Dyslipidemia and associated factors among adult patients on antiretroviral therapy in armed force comprehensive and specialized hospital, Addis Ababa, Ethiopia. HIV/AIDS (Auckland NZ). 2020;12:221.

    Google Scholar 

  31. Achila OO, Abrhaley F, Kesete Y, Tesfaldet F, Alazar F, Fisshaye L, et al. Dyslipidemia and associated risk factors among HIV/AIDS patients on HAART in Asmara, Eritrea. PLoS ONE. 2022;17(7):e0270838.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Lippi G, Albiero A, Montagnana M, Salvagno GL, Scevarolli S, Franchi M, et al. Lipid and lipoprotein profile in physiological pregnancy. Clin Lab. 2007;53(3–4):173–7.

    CAS  PubMed  Google Scholar 

  33. Jansen H, Verhoeven AJ, Sijbrands EJ. Hepatic lipase. J Lipid Res. 2002;43(9):1352–62.

    Article  CAS  PubMed  Google Scholar 

  34. Kim HJ, Park HA, Cho YG, Kang JH, Kim KW, Kang JH, et al. Gender difference in the level of HDL cholesterol in Korean adults. Korean J Family Med. 2011;32(3):173.

    Article  Google Scholar 

  35. Ge P, Dong C, Ren X, Weiderpass E, Zhang C, Fan H, et al. The high prevalence of low HDL-cholesterol levels and dyslipidemia in rural populations in Northwestern China. PLoS ONE. 2015;10(12):e0144104.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Marhoum TA, Abdrabo AA, Lutfi MF. Effects of age and gender on serum lipid profile in over 55 years-old apparently healthy Sudanese individuals. Asian J Biomedical Pharm Sci. 2013;3(19):10.

    Google Scholar 

  37. Taramasso L, Tatarelli P, Ricci E, Madeddu G, Menzaghi B, Squillace N, et al. Improvement of lipid profile after switching from efavirenz or ritonavir-boosted protease inhibitors to rilpivirine or once-daily integrase inhibitors: results from a large observational cohort study (SCOLTA). BMC Infect Dis. 2018;18(1):357.

    Article  PubMed  PubMed Central  Google Scholar 

  38. NCEP. Third report of the National Cholesterol Education Program (NCEP). Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). The Program; 2002.

  39. WHO. Cardiovascular diseases (CVDs). 2021.

  40. WHO. Physical status: the use of and interpretation of anthropometry. Report of a WHO Expert Committee: World Health Organization; 1995.

    Google Scholar 

  41. Riley L, Guthold R, Cowan M, Savin S, Bhatti L, Armstrong T, et al. The World Health Organization STEPwise Approach to Noncommunicable Disease risk-factor surveillance: methods, challenges, and opportunities. Am J Public Health. 2015;106(1):74–8.

    Article  Google Scholar 

  42. Kabwama SN, Ndyanabangi S, Mutungi G, Wesonga R, Bahendeka SK, Guwatudde D. Alcohol use among adults in Uganda: findings from the countrywide non-communicable Diseases risk factor cross-sectional survey. Glob Health Action. 2016;9:31302.

    Article  PubMed  Google Scholar 

Download references


We would like to thank Fogarty International Center of the National Institutes of Health, the funders of this research. We extend our gratitude to Professor Joan N Kalyango, Dr. Achilles Katamba, and Dr. Edith Namulema for their invaluable guidance throughout this work. Additionally, we appreciate the support of the study participants, staff and administration of Mengo Hospital.


Research reported in this publication was supported by the Fogarty International Center of the National Institutes of Health under Award Number D43TW009771. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

The Medical Research Council (MR/V03510X/1) provided financial support during the writing of this manuscript.

Author information

Authors and Affiliations



VJK designed the project, carried out the data analysis, interpretation of the results and wrote the preliminary reports with input from BC, ADK and JIN. RKM and AK conceptualized the research idea. Results were discussed among the authors. RS, AK, RK, FEK and BC drafted the manuscript. FEK, AK and RK supervised the overall manuscript writing process while BC supervised the entire study process. All authors read and approved the submission of this manuscript.

Corresponding author

Correspondence to Vianney John Kigongo.

Ethics declarations

Ethical approval and consent to participate

Permission to conduct the study was sought from Makerere University Clinical Epidemiology Unit and ethical approval from School of Medicine Research Ethics Committee (Mak-SOMREC-2022-339). Administrative clearance was obtained from Mengo Hospital, Kampala, Uganda. Written informed consent was obtained from all participants prior to enrollment into the study.

Consent for publication

Not applicable.

Conflict of interest

The authors declare no conflict of interest.

Competing interests

The authors declare that they have no competing interests.

Patient consent

Written informed consent was obtained from all participants prior to enrollment into the study.

Provenance and peer review

Not commissioned; not peer reviewed.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic Supplementary Material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kigongo, V.J., Nankabirwa, J.I., Kitutu, F.E. et al. Dyslipidemia among adult people living with HIV on dolutegravir – based antiretroviral therapy at a private tertiary hospital in Kampala, Uganda: burden and determinants. BMC Infect Dis 24, 53 (2024).

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: